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Patient Safety Learning

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Everything posted by Patient Safety Learning

  1. Content Article
    The president of the Vascular Society of Great Britain and Ireland, Chris Imray, has issued a letter to Vascular Society members on the COVID-19 virus and vascular surgery, offering “general principles” on vascular patients and COVID-19, elective surgery and outpatients, urgent vascular surgery, trainees, other specialities, the appropriate use of scarce resources, documentation, personal safety, mental health and burnout, research, clinical training/education, and audit. Imray stresses that “local decision making is key.
  2. Content Article
    "My blood ran cold when I was instructed to conserve personal protective equipment in the fight against COVID-19. Masks and other supplies are severely limited. Rather than following deeply ingrained safety standards, healthcare providers across the country are switching to what the Centers for Disease Control and Prevention calls “strategies that are not commensurate with U.S. standards of care.” In her blog published in the Washington Post, Dorothy Novick, a paediatrician in Philadelphia, highlights the lack of personal protective equipment in the US and why the shortage of protective equipment is not only a crisis for healthcare providers on the front lines but also a potential disaster for patients.
  3. News Article
    Lack of staff testing, workforce shortages and running out of personal protective equipment (PPE)are the three biggest concerns for trusts fighting the coronavirus outbreak, according to an HSJ chief executive survey conducted over the last 36 hours. Thirteen of the 34 trust chief executives who responded to the snap survey, who were from trusts across England, also warned they would run out of intensive care capacity by next week as the number of coronavirus cases continue to rise. The survey also revealed some trusts were already being forced to dilute safe staffing ratios and ration facilities. One chief warned: “We are preserving ventilation capacity by ensuring that only those who may survive are considered.” However, the majority of respondents were supportive of system leaders’ guidance so far. Several respondents praised the “impressive pace and detail of the advice." The three biggest areas of concern raised by the chiefs surveyed were: Lack of staff testing, raised by 26 of the 34 respondents (77%); Staff shortages, raised by 26 of the 34 respondents (77%); and PPE shortages, raised by 23 of the 34 respondents (68%. Read full story Source: HSJ, 24 March 2020
  4. Community Post
    Tweet from Hugh Pym:
  5. News Article
    UK doctors fighting coronavirus still say they don't have personal protective equipment (PPE). Jon Snow spoke to Dr Jenny Vaughan, a leading member of the Doctors’ Association who have written to the government to demand better personal protective equipment for medical staff. He asked her whether the PPE equipment promised by the government was starting to reach the medical staff on the frontline, and what kinds of problems medical personnel had been encountering. Watch news story Source: Channel 4 News, 23 March 2020
  6. Content Article
    After a year of attending lectures on pre-clinical medicine, Usama Ali found herself on the wards for the first time. Except for her, things were different. She was there as a patient in a psychiatric ward. In this BMJ article, Usama reflects on her experience and explains how the whole patient journey can influence recovery.
  7. News Article
    University Hospitals has partnered with medical technology company Masimo to pilot a telehealth solution, Masimo SafetyNet, that is designed to help clinicians care for patients remotely with a finger sensor and phone app. The demand for remote monitoring and patient engagement in different settings has "significantly increased" during the COVID-19 pandemic. To help prepare for a surge in COVID-19 patients and protect other patients and providers, the tool allows University Hospitals and other hospitals to expand patient monitoring to the home or other locations (for instance, a skilled nursing facility or an under-utilised med-surg floor) that are temporarily set up to address increased demand. Guidelines from the World Health Organization suggest monitoring the oxygen saturation, respiration rate and temperature of suspected or confirmed COVID-19 patients. Adapting this existing technology aims to offer a secure remote solution. Read full story Source: Crain's Cleveland Business, 23 March 2020
  8. News Article
    A leading NHS doctor has warned frontline medical staff dealing with Britain’s coronavirus outbreak feel like “cannon fodder” and "lambs to the slaughter". Dr Rinesh Parmar, chairman of the Doctor's Association UK, is battling the disease on an intensive care ward at a city hospital in Birmingham. The Anaesthetic Registrar begged Boris Johnson to provide better Personal Protective Equipment (PPE), describing the current crisis the "calm before the storm" Doctors and nurses fear a lack of masks, gloves, aprons and protective suits is putting them at risk as they care for patients diagnosed with Covid-19. Speaking after a night shift on the ward, Dr Parmar told The BBC's Andrew Marr Show: "We have had doctors tell us they feel like lambs to the slaughter, that they feel like cannon fodder. GPs tell us that they feel absolutely abandoned." Read full story Source: The Sun, 23 March 2020
  9. Content Article
    Governments are taking a wide range of measures in response to the COVID-19 outbreak. The Oxford COVID-19 Government Response Tracker (OxCGRT) aims to record these unfolding responses in a rigorous, consistent way across countries and across time.
  10. News Article
    The staff-to-patient ratios for intensive care are being dramatically reduced as the NHS seeks to rapidly expand its capacity to treat severely ill covid-19 patients, HSJ has learned. Acute trusts in London have been told to base their staffing models for ICU on having one critical care nurse for every six patients, supported by two non-specialist nurses and two healthcare assistants. Trusts have also been told by NHS England and NHS Improvement’s regional directorate to plan for one critical care consultant per 30 patients, supported by two middle grade doctors. The normal guidance is the consultant-to-patient ratio “should not exceed a range between 1:8-1:15”. Nicki Credland, chair of the British Association of Critical Care Nurses, confirmed the plans had been agreed today nationally. She told HSJ: “There will absolutely be a lot of concern about this in the profession, but it’s the only option we’ve got available. We simply don’t have the capacity to increase our staffing levels quickly enough." “It will dilute the standard of care but that’s absolutely better than not having enough critical care staff. There’s also a massive issue around the ability of critical care nurses not only to care for their patients but also monitor what the non-specialists in their teams are doing.” Read full story (paywalled) Source: HSJ, 24 March 2020
  11. News Article
    Delays have begun to cancer treatments, as patients are reprioritised ahead of capacity becoming overwhelmed by the coronavirus crisis. In three separate developments: A London trust announced it was cancelling chemotherapy and routine cancer operations for a fortnight due to coronavirus pressure; An NHS England covid-19 guidance document indicated palliative care cancer patients will be less likely to receive appropriate treatment; and Cancer waiting times guidance has been changed to provide for some urgent referrals for suspected cancer to be sent back to GPs without diagnosis. Read full story (paywalled) Source: HSJ, 23 March 2020
  12. News Article
    A new ventilator, a virus-killing snood and a hands-free door pull are just some of the innovations coming out of Wales to tackle coronavirus. Since the outbreak, doctors, scientists and designers have been working on ideas to stop the virus spreading. The ventilator has already successfully treated a Covid-19 patient and has been backed by the Welsh Government. Mass production of the snood-type mask is under way while a 3D design of the handle has been widely circulated. Plaid Cymru leader Adam Price, who was part of the impetus to get the ventilator into mass production, said the innovations put Wales "on the front foot" in the battle against the pandemic. "It shows that Wales, as a small nation, can get things done quickly as we face the biggest challenge of our generation," he said. Read full story Source: BBC News, 24 March 2020
  13. News Article
    A Covid-19 test can deliver results in less than an hour has been approved under an FDA emergency authorization, marking the first test that clinicians can use at the bedside. Cepheid, a Silicon Valley molecular diagnostics company that’s a unit of Danaher Corp., announced Saturday it received an emergency authorisation from the U.S. Food and Drug Administration to use the test, making it the 13th Covid-19 test the agency has allowed on the market as long as the public health emergency exists. But it’s the first one that can be used at the point of care, meaning providers don’t have to send patient samples to a separate lab to be processed and then come back to the hospital or provider’s office. Cepheid said it expects to start shipping tests next week. “An accurate test delivered close to the patient can be transformative — and help alleviate the pressure that the emergence of the 2019-nCoV outbreak has put on healthcare facilities that need to properly allocate their respiratory isolation resources,” said David Persing, Cepheid Chief Medical and Technology Officer. Read full story Source: Bloomberg, 21 March 2020
  14. News Article
    WHO has launched a messaging service with partners WhatsApp and Facebook to keep people safe from coronavirus. This easy-to-use messaging service has the potential to reach 2 billion people and enables WHO to get information directly into the hands of the people that need it. From government leaders to health workers and family and friends, this messaging service will provide the latest news and information on coronavirus including details on symptoms and how people can protect themselves and others. It also provides the latest situation reports and numbers in real time to help government decision-makers protect the health of their populations. The service can be accessed through a link that opens a conversation on WhatsApp. Users can simply type “hi” to activate the conversation, prompting a menu of options that can help answer their questions about COVID-19. The WHO Health Alert was developed in collaboration with Praekelt.Org, using Turn machine learning technology. Read full story Source: World Health Organization, 20 March 2020
  15. News Article
    A mental health charity has branded as “irresponsible” the Government’s coronavirus bill which would grant single doctors the power to detain the mentally ill. The Government wants to relax legal safeguards in the Mental Health Act in order to free up medical staff to deal with the COVID-19 pandemic. If passed, the bill would reduce the number of doctors needed to approve detaining individuals from the current minimum of two, to just one. In addition, it would temporarily allow time limits in the Mental Health Act to be extended or removed altogether. This would mean patients currently detained in mental health facilities could be released into the community early, or be detained for longer. Akiko Hart, Chief of National Survivor User Network (NSUN), a UK mental health charity, said: “Whilst we understand that these are unprecedented times, any legislative change must be proportionate and thought through, and should protect all of us. Minimising some of the safeguards in the Mental Health Act and extending its powers, is a step in the wrong direction.” Read full story Source: The London Economic, 19 March 2020
  16. News Article
    New guidelines have been published to help doctors and nurses decide how to prioritise patients during the coronavirus pandemic. The advice from the National Institute for Health and Care Excellence (NICE) was produced amid concerns that the NHS would be overwhelmed by the demand for intensive care beds and ventilators. The three new NICE guidelines, which have been drawn up within a week rather than the usual timescale of up to two years, cover patients needing critical care, kidney dialysis and cancer treatment. They say all patients admitted to hospital should still be assessed as usual for frailty “irrespective of Covid-19 status”. Decisions about admitting patients to critical care should consider how likely they are to recover, taking into account the likelihood of recovery “to an outcome that is acceptable to them”. Doctors are advised to discuss possible “do not resuscitate” decisions with adults who are assessed as having increased frailty, such as those who need help with outside activities or are dependent for personal care. Read full story Source: Independent, 22 March 2020
  17. News Article
    The number of heart and lung transplants could quadruple thanks to a "reanimation" machine used in a pioneering operation, a hospital says. The device, developed at Royal Papworth Hospital in Cambridge, managed to pump oxygenated blood into both organs in a world-first procedure. The machine can revitalise deteriorating organs allowing "donation after circulatory death" (DCD). Hospital surgeon Pedro Catarino said it was like "recharging the batteries". "It is reanimation and then it replenishes the energy stores of the heart, what we call reconditioning, which allows it be transplanted," he said. "We think it could at least double and perhaps quadruple the number of [heart and lungs] available for transplant." He said it was desperately needed, adding: "Patients die on the waiting list every day." Read full story Source: BBC News, 23 March 2020
  18. News Article
    The health secretary has acknowledged there have been "challenges" with the supply of personal protective equipment to NHS staff in England - but added he is determined to rise to them. Last week, NHS staff said the lack of protective gear was putting them at risk during the coronavirus outbreak. Matt Hancock said a million face masks had been bought over the weekend and he was taking the issue "very seriously". From this week, the Army will play a part in helping to distribute supplies. "I am determined to ensure that the right kit gets to the right hospital, the right ambulance service, the right doctors' surgery, right across the country," said Mr Hancock. "There have been challenges and I can see that. We're on it and trying to solve all the problems." Read full story Source: BBC News, 23 March 2020
  19. Content Article
    Patients in inpatient mental health settings face similar risks (e.g., medication errors) to those in other areas of healthcare. In addition, some unsafe behaviours associated with serious mental health problems (e.g., self-harm), and the measures taken to address these (e.g., restraint), may result in further risks to patient safety. The objective of this review from Thibaut et al., published in BMJ Open, was to identify and synthesise the literature on patient safety within inpatient mental health settings using robust systematic methodology. The authors found that patient safety in inpatient mental health settings is under-researched in comparison to other non-mental health inpatient settings. Findings demonstrate that inpatient mental health settings pose unique challenges for patient safety, which require investment in research, policy development, and translation into clinical practice.
  20. Content Article
    Freedom to Speak Up Guardians are changing the conversation about what it means to speak up in health. With a network of over 1,100 guardians and champions in England, workers are being supported and positive actions are being taken as a result. Speaking up and listening up should be a natural part of our conversations with colleagues, managers and each other. In health, as in all sectors, the best leaders understand the importance of listening to workers who are the eyes and ears of an organisation. But in health it is even more crucial as speaking up can be a matter of life or death. A positive environment and a supportive culture are key elements of the NHS People Plan. The Freedom To Speak Up Index, a new metric taken from the NHS Annual staff survey, shows that a positive speaking up culture may be correlated with higher performing organisations.  The National Guardian Freedom to Speak UP launched the 100 Voices campaign: to share the stories that describe the current reality of speaking up in health. This document highlights and shares best practice in speaking up. Some have been provided by Freedom to Speak Up Guardians, others by workers themselves. Within these pages you will hear a selection of voices. They describe their experiences of speaking up, the impact this has had and how it has led to positive change.
  21. Content Article
    Lots of our children are worried about the coronavirus (COVID-19) pandemic, so the Maltings Surgery put together a short explainer video to help lower the anxiety levels amongst our younger generation. Be kind to each other and yourselves.
  22. News Article
    Nurses caring for patients in the community have been spat at and called ‘disease spreaders’ by members of the public, according to England’s chief nurse and the Royal College of Nursing (RCN). The nursing union urged members of the public to support the UK’s “socially critical” nursing workforce during the coronavirus outbreak. The RCN said it had received anecdotal reports of community nurses receiving abuse while working in uniform. Separately, England’s Chief Nurse Ruth May said she had heard reports of nurses being spat at. Susan Masters, the RCN’s director of policy, said abuse of nurses was “abhorrent behaviour”. She said a number of nurses had raised concerns about abuse on forums used by members to talk confidentially. Describing one incident she told The Independent: “These were community nurses who had to go into people’s homes and were in uniform. Members of the public who saw them called out to them and said they were ‘disease spreaders’.” She added: “We don’t know how big this problem is, it is anecdotal, but it is absolutely unacceptable. Read full story Source: The Independent, 21 March 2020
  23. News Article
    Palliative care doctors are urging people to have a conversation about what they would want if they, or their loved ones, became seriously unwell with coronavirus. We should discuss all possible scenarios - even those we are not "comfortable to talk about", they said. Medics said the virus underlined the importance of these conversations. New guidelines are being produced for palliative care for Covid-19 patients, the BBC understands. Read full story Source: BBC News, 21 March 2020
  24. Community Post
    Why aren't staff being protected more? Read this anonymous blog from a hub member on why she is angry and scared.
  25. Community Post
    A member of the hub has just shared the nightmare she is currently living through with her 25-year-old son who has significant cerebral palsy due to kernicterus and is speech, hearing and motor impaired but is isolated with no help. What more should be done? Do you have a similar story to share? How can we protect the most vulnerable during this pandemic? Add your comments below.
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